Organization
A&E SUPPORTED LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MELISSA ANN EZELL MS (CEO)
(251) 232-2548
Entity
Organization
Contact information
Practice address
600 BEL AIR BLVD, SUITE 240, MOBILE, AL 36606-3501
(251) 232-2548
(251) 661-5080
Mailing address
3204 WELLBORNE DR E, MOBILE, AL 36695-3273
(251) 232-2548
(251) 661-5080
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/20/2007
Last updated
06/24/2008
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